Various medical procedures, particularly cardiology procedures, involve accessing a corporeal vessel through the formation of a hole or opening in the vessel wall so that a medical procedure can be performed. After the particular medical procedure has been performed, the access hole in the vessel wall must be closed. A number of prior vascular closure devices and methods have been developed in attempting to provide a solution for the problem of closing a hole in the vessel wall. Tissue approximation typically involves passing a length of suture into and through adjacent vessel and subcutaneous tissue, across the vessel opening, and back into and through adjacent vessel and subcutaneous tissue. Certain prior closure devices have involved relatively complicated methods and devices for extracting a length of suture from inside the vessel so that the physician can approximate tissue surrounding the hole in the vessel wall through use of the suture.
U.S. Pat. No. 5,643,292 and U.S. Pat. No. 6,059,800 disclose example prior suturing devices used for approximating tissue surrounding the opening in a vessel wall. Most prior closure devices enlarge the vessel opening thereby negating the benefits of using smaller or less invasive percutaneous products. Prior suturing devices are also relatively complicated and difficult to use. Furthermore, many suturing devices dilate the vessel opening and perform the medical procedure via the vessel opening before the suture is extended across the vessel opening for approximation tissue surrounding the vessel wall.
In many prior art systems, needle deployment is done manually by a physician or operator. Manual deployment involves estimation by the operator of how the needle should be deployed, how fast the trigger for the needle should be actuated, how much force should be applied, etc. The manual method of needles deployment require the physician to manually pull a lever or button proximally to deploy the needles. The speed or force used to actuate the lever or button will determine the force the needle will have when penetrating the artery. The more force the needle have in penetrating the artery the greater the possibility of piercing an artery. Thus, the physician must exert sufficient force to penetrate the artery but take care not to exert so much force as to pierce the artery. Manual deployment allows for greater inconsistency and user error as different physicians have differing perception when it comes to how much force or speed to apply when using a device. It would be advantageous to have a device for automated needle deployment that reduces operator estimation and, thus, operator error, and standardizes deployment of the needle.
Typically, the suture securing the hole in the vessel wall is closed using a sliding knot. The knot can be slid along the suture. Thus, the surgical site is contacted with a sliding suture when the knot is pushed or cinched down and thus causes movement of the suture at the tissue site. Tying of the suture with an over hand suture loop enables sliding of the knot while the suture at the tissue site remains stationary. A device for transporting two or more over hand suture loops to percutaneous surgical site thus would also be useful.